PAYER READY CREDENTIALING & COMPLIANCE

For RCM Organizations

You bill. We keep the providers billable.

Every denial that traces back to a lapsed license, a stale CAQH attestation, or an enrollment nobody finished is revenue your team eats. PayerReady runs credentialing for your client practices upstream of your billing, so the claims you submit are backed by current credentials the first time.

$99 per application at 51+ providers Your client relationships stay yours We never touch claims
app.payerready.com · Network Grid
The Network Grid crossing every payer with every provider so an RCM team sees participation and gaps per client

Denials prevented upstream

Credentials verified before claims

The same claim, two credentialing realities

Top lane: the claim rides on stale credentials and dies at adjudication. Bottom lane: credentials verified upstream, claim pays the first time.

Without verified credentialing
Claim denied at the payer, rework, resubmit, wait
With PayerReady upstream
Credentials verified first, claim pays the first time

Every client roster, one console

Real screens from the platform your team would work in, across every client practice you manage.

Readiness scored across every client

Each client practice gets its own roster and compliance view, and your team works across all of them from one login. Before a billing cycle starts, you can see which provider at which client has a lapsed license, an overdue CAQH attestation, or an unfinished enrollment, and fix it before it becomes a denial batch.

  • Per client rosters with readiness per provider
  • OIG and SAM screening across the whole book
  • 90, 60, and 30 day alerts before anything lapses
Provider Compliance · per client
The Provider Compliance view scoring each provider for readiness so an RCM team can catch problems before billing
Smart Enrollment · every application
The Smart Enrollment tracker showing payer applications with live status so nothing sits unworked

A credentialing service line without the headcount

Offer credentialing to your clients without hiring a credentialing department. Your clients get enrollments worked on a two week follow up cadence by PayerReady specialists, you get the differentiator and keep the relationship. We stay in our lane: we never touch claims, and the final say on every submission stays with you and your client.

  • Specialists prepare, submit, and chase every application
  • Every payer response logged on the file your team can read
  • Client relationships and billing stay entirely yours

Credentialing failures are billing failures wearing a disguise

Your analysts see them as denial codes. Your clients feel them as missing revenue. The root cause sits upstream of both.

The provider enrollment denial family

CO-183, CO-8, B7: adjudication codes that all translate to the same sentence, the rendering provider was not properly enrolled with this payer on the date of service. They are unappealable in the ordinary sense because the payer is right. The only fix is upstream, before submission.

Rework that never invoices

Every credentialing denial consumes analyst time twice: once to research why a clean looking claim died, once to resubmit after the enrollment is cured. That labor rarely gets billed back to anyone. It quietly compresses your margin on every affected client, month after month.

Client churn traced to onboarding stalls

When a client adds a provider and that provider sits unbillable for five months, the client does not blame the payer. They blame their billing partner. Time to first clean claim is the number new clients judge you on, and credentialing is usually what is holding it hostage.

The credentialing arm your firm never had to build

Full scope, across every client roster you manage, with your firm in front.

Multi client roster operations

Each client organization gets its own roster, network grid, and compliance view. Your team works across the whole book from a single login with per client separation intact.

Enrollment worked to approval

Applications prepared against payer specific requirements, submitted, and chased on a two week cadence with every response logged where your analysts can read it.

Participation gap detection

The Network Grid crosses every payer with every provider per client. Gaps surface as actionable tiles before a submitted claim finds them the expensive way.

Continuous compliance screening

Licenses, DEA registrations, certifications, and CAQH attestations tracked across every client, with OIG and SAM exclusion screening on a standing schedule.

EDI, ERA and EFT enrollment

Electronic claims routing, remittance, and deposit enrollment configured payer by payer for each client, so your posting workflows receive 835s instead of paper.

Reporting your clients can see

Enrollment progress, license status, and compliance standing exportable per client as PDF or CSV, ready to drop into your monthly client reviews.

How the partnership runs

Four steps to a credentialing service line, with clean boundaries the whole way.

1

Step one

Bring a client roster

Register the client organization, add providers by NPI with NPPES prefill, or invite them to complete their own profiles. Existing in flight applications get picked up and their true status verified.

2

Step two

We run the files

Specialists prepare and submit every application, work CAQH and PECOS, and chase payers on a two week cadence. Volume pricing applies across your combined book: $99 per application at 51+ providers.

3

Step three

Your team supervises

Analysts watch the Network Grid and compliance views instead of payer hold music. Readiness surfaces per provider before each billing cycle, and every payer response sits logged on the file.

4

Step four

Your brand stays forward

You present credentialing as your capability in client reviews, backed by exportable per client reporting. The client relationship, the billing, and the final say stay entirely yours.

For billing partners

The unit economics of the partnership

What the credentialing arm costs, and what it quietly removes from your denial queue.

01

$0

per application at book volume

Your combined client rosters reach the 51+ provider band quickly, and stay there.

02

0

login across every client practice

Per client separation for the data, one console for your analysts to work the whole book.

03

0 weeks

maximum between payer follow ups

Enrollment files never sit unworked long enough to become next month’s denial batch.

04

0

payer relationships, all 50 states

Wherever your clients practice, the payer contacts and requirements already exist here.

RCM partnership questions, answered straight

Boundaries, pricing, and who owns what.

PayerReady acts as your verified data source. We deliver clean, organized provider data that your team can pull into whatever billing system you already use. No custom integration required to get started.

No, that is your expertise and we stay out of it. We make sure the provider is properly credentialed, enrolled, and compliant so that when your team submits the claim, it goes through the first time.

You can offer credentialing as part of your service without building the infrastructure yourself. Clients get faster enrollment, you get a value add that differentiates you from other RCM firms, and the client relationship stays entirely yours.

Provider licenses, certifications, CAQH attestations, and expiration dates are tracked automatically, with OIG and SAM exclusion screening on a schedule. The platform alerts you before anything lapses so your billing activity is always backed by current credentials.

Per application, banded by total roster size: $139 at 1 to 20 providers, $109 at 21 to 50, and $99 at 51 and up. An RCM firm managing several client rosters reaches the volume bands quickly, and you always see the price before an application starts.

Yes. Each client organization gets its own roster, network grid, and compliance view, and your team works across them from one login. You always know which provider at which client is blocking which payer.

Every month un-credentialed is revenue you never bill

Sign up free, add your first provider, and watch the pipeline start moving this week.

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Answers from your credentialing team's verified knowledge base

Hi, I'm CredBrain. I answer from your credentialing team's verified knowledge base: payer join paths, state rules, timelines, associate billing, and enrollment workflows. If I don't have a verified answer, I'll say so and point you to your team. What would you like to know?

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